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Sicular > Day 9 - OBGYN > Flashcards

Day 9 - OBGYN Flashcards

1
Q

down syndrome top causes (1-3)?

A

1) Meiotic nondisjunction
2) Inherited Robertsonian translocation
3) Mosaicism

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2
Q

Siblings w/ down syndrome+ now another kid w/ down syndrome = cause think?

A

Robertsonian translocation (Inherited)

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3
Q

MVA w/ pregnant woman - concerned for?

A

Placenta abruption

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4
Q

Mastitis + no abscess - most common cause?

A

Staph

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5
Q

Mastitis + no abscess - treat?

A

Something that covers Staph

- nafcillin, diclox

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6
Q

Mastitis + w/ abscess - treat?

A
  • incision and drainage

- abx (cover staph)

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7
Q

What should be given orally shortly before receiving an epidural?

A

Antacid

(and no meals bc concern for aspiration)

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8
Q

Release of thromboplastic substances from placental tissue can cause?

A

DIC

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9
Q

Vacuum advantage over forceps?

A

Vacuum does not occupy space next tot he fetal head

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10
Q

contraindications for vacuum?

A
  • face presentation

- breech presentation

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11
Q

Workup of syphilis?

A
  • Screening test: RPR or VDRL

- Confirmatory test: MHA-TP or Dark field microscopy

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12
Q

Treatment of syphilis?

A

Penicillin (all pts even if preggers)

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13
Q

Allergic to penicillin, preggers, but have syphilis, treatment?

A

Skin test, if true –> Desentisization –> Penicillin

not preggers could use 2nd line ones [ie doxy] but those are teratogenic

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14
Q

complete abortion, treatment?

A
  • Counseling for pt

- No remaining POCs –> nothing specific to follow

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15
Q

early decelerations caused by?

A

head compressions

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16
Q

variable deceleration caused by?

A

cord compression

(multiple causes - low amniotic fluid, cord prolapse, etc)

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17
Q

Late decelerations caused by?

A

Uteroplacental insufficiency

- (multiple causes - abruption, cocaine, etc)

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18
Q

painless vag bleeding think?

A

placenta previa

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19
Q

Painful vag bleeding think?

A

Abruption

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20
Q

lecithin to sphigomyelin ratio ideal?

A

2: 1

- below that –> give steroids to mature lungs if need to deliver

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21
Q

Nitrazine paper test is?

A

test to see if fluid is amniotic fluid (ie Premature ROM)

- blue = amniotic

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22
Q

Ferning pattern = think?

A

Amniotic fluid (ie PROM)

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23
Q

What week do you give RHoGAM and to whom?

A

@ 28 wks to Rh- mom

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24
Q

Typical treatment for GBS?

A

Pencillin G

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25
Q

Treatment for GBS to severe penicillin allergic pt?

A

Vancomycin

- Can’t give cefazolin b/c cross reactivity w/ pencillin

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26
Q

Pregnant woman has lower hematocrit, why?

A

Decreased ratio of RBC to plasma (bc vol goes up)

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27
Q

Prolapsed cord, treat?

A

Perform an emergency C section

- DON”T TOUCH THE CORD

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28
Q

Treat hypermagnesemia?

A

Calcium gluconate

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29
Q

Breech position, when do you do what?

A 
expectant management (still has time to rotate)
>36wk --> External cephalic version
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30
Q

Indications for GBS treatment during labor?

A
  • Previous child w/ GBS sepsis
  • Previous GBS in earlier point in this pregnancy
  • Positive cx at 34-36 wks
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31
Q

Causes of abortions by trimester

A

1st - genetic abnormalities in fetus

2nd & 3rd - maternal issues

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32
Q

asymptomatic U/A w/ E.coli treat?

A

Oral Abx

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33
Q

preggers, 2 time asymptomatic E.Coli on urine cx, treatment?

A
  • Oral Abx

- Start prophylactic Abx for remainder of the pregnancy

34
Q

Asymmetric IGUR?

A

Maternal issue

- HTN, later start

35
Q

Symmetric IGUR

A
  • Fetal issue

- infx, earlier start

36
Q

Most common cause of post-partum hemorrhage?

A

Uterine atony

“spongy soft uterus”

37
Q

Management of post-partum hemorrhage?

A

1) fundal massage

2) med to contract uterus (oxytocin, prostaglandin, etc)

38
Q

Low Transverse has highest risk of predisposing pt to?

A

Placenta Accreta

- not associated w/ uterine rupture

39
Q

deceleration w/ no relation to uterine contractions means?

A

umbilical cord compression

variable decels

40
Q

Painless serous discharge - think?

A

Chlamydia

41
Q

calymmatobacterium granulomatous has no what?

A

Lymphadenopathy

42
Q

creamy purulent discharge = think?

A

gonorrhea

43
Q

DVT treatment

A

Firstline: LMWH

  • -> treat for a long time: bridge to warfarin, INR of 2-3
  • -> only, if only treating for a short time
44
Q

Greatest risk from having ovarian teratoma?

A

Torsion

45
Q

acute-angle glaucoma + urge incontinence, can’t give?

A
  • oxybutynin (anticholinergic, antimuscerinic)

- Imipramine (TCA)

46
Q

Neonatal conjuntivitis 2-4 days post birth, cause?

A

Gonorrhea

47
Q

Urge incontinence, good test?

A

Cystometry (checks strength of muscle)

48
Q

unscheduled bleeding contraceptive most commonly?

A

Depo

49
Q

w/in 3 mo of STD, shouldn’t use what contraception?

A

IUD

“w/in 3 mo of STD, can’t put in an IUD”

50
Q

First sign of puberty in female?

A

Thelarche (boobs)

51
Q

First sign of puberty in boys?

A

Growth of testicles

52
Q

KOH pos test = think?

A

Gardnerella

53
Q

Contraception effects malignancy risks how?

A

INC cancers w/ CONsonant
(ie HCC, Bone cancer, Breast, cervical)

DEC cancers that start w/ vowels (ie Ovarian, Endometrial)

54
Q

Vulvar itching + white plaque + excoriations = think?

A

Lichen sclerosis

55
Q

Treat lichen sclerosis w/?

A

Clobetasol cream (high dose steroid)

56
Q

Most common cause of heavy menstrual bleeding?

A

Anovulation (dysfunctional ovulation due to unopposed estrogen)

  • Estrogen too high in that cycle
57
Q

Treat anovulation?

A

mild - expectant management
mod - oral cyclic progestins
severe - fluids, IV progesterone

58
Q

Dysfunctional uterine bleeding (DUB)

A

Unopposed estrogen (too high compared to progesterone) –> too much endometrium made –> heavy periods

59
Q

Most common cause of heavy menstrual bleeding if everything appear normal (ie nL H&P, labs, etc)

A

Dysfunctional uterine bleeding (DUB)

60
Q

Only thing you might find on abl w/ dysfunctional uterine bleeding?

A

Maybe thickened endometrium on imaging

61
Q

Neonatal conjunctivitis 1-2wks post birth = think?

A

Chlamydia

- treat w/ oral macrolide

62
Q

differentiate androgen insensitivity syndrome from mullerian agenesis?

A

AIS - no pubic or axillary hair, testes on imaging

MA - hair, ovaries on imaging

63
Q

biopsy + complex fluid collection posterior to the uterus - think?

A

Uterine perforation

64
Q

Q-tip test dx what?

A

Stress Incontinence

65
Q

Tamoxifen inc risk for?

A

Endometrial changes –> endometrial CA

66
Q

Treatment of dysfunctional

A

mild - nothing or OCP
mod - Oral High dose progesterone (+/- estrogen)
severe - fluids + IV hormones

67
Q

cervical motion tenderness think?

A

Pelvic Inflammatory Disease

68
Q

fertility treatment + ovarian problem = think?

A

ovarian hyperstimulation syndrome

69
Q

febrile + sore throat + cervical tenderness = think?

A

PID

70
Q

most common PMS symptom?

A

Abdominal bloating

71
Q

older woman w/ breast problem + no discrete mass + skin changes - think?

A

Inflammatory cancer

72
Q

Paget’s disease effects where?

A

Nipple

73
Q

Ulcerative lesion at nipple think?

A

Paget’s disease

74
Q

Treatment of uncomplicated UTI?

A

Oral TMP-SMX for 3 days

75
Q

Pain on menses + pain on BM + infertility - think?

A

Endometreosis

76
Q

Most likely location of endometriosis?

A

Fallopian tubes

(b/c retrograde endometrial sloughing –> backward from uterus –> fallopian tubes –> ovaries –> uterine ligaments –> etc)

77
Q

enlarged uterus in reproductive age female - think? (2)

A
  • Leiomyosis (fibroids, irregular)

- Adenomyosis (symmetrical, cystic findings)

78
Q

hypothyroidism can predispose females to what?

A

anovulation –> DUB –> heavy menstrual bleeding

79
Q

prolactinoma workup?

A

1) prolactin levels
2) MRI of brain
3) if there –> bromocriptine
4) if meds don’t solve, surgery

80
Q

1st step in fertility workup?

A

Semen analysis

Sicular (9 decks)

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